二甲双胍对 2 型糖尿病患者肺癌风险和生存的影响：一项荟萃分析。

The effect of metformin on lung cancer risk and survival in patients with type 2 diabetes mellitus: A meta-analysis.

机构信息

Department of Clinical Pharmacy, The First Affiliated Hospital of Shandong First Medical University, Shandong First Medical University, Jinan, China.

Department of Clinical Pharmacy, China Pharmaceutical University, Nanjing, China.

出版信息

J Clin Pharm Ther. 2020 Aug;45(4):783-792. doi: 10.1111/jcpt.13167. Epub 2020 May 14.

DOI:10.1111/jcpt.13167

PMID:32406122

Abstract

WHAT IS KNOWN AND OBJECTIVE

Metformin has received increasing attention owing to its potential protective effect against cancer. We aimed to summarize evidence regarding the association between metformin and the risk or survival in lung cancer patients with type 2 diabetes.

METHODS

We selected observational studies examining the association between exposure to metformin and the risk or survival in lung cancer. Available publications were searched in PubMed, Cochrane Library, ScienceDirect, Wiley and SpringerLink databases. Meta-analysis was performed with hazard ratios (HRs) and 95% confidence intervals (95% CIs) as effect measures for risk or survival in lung cancer.

RESULTS

Eighteen studies (eight on lung cancer risk and ten on lung cancer survival) were included. Metformin treatment was associated with decreased lung cancer incidence (HR 0.78; 95% CI 0.70-0.86) and increased lung cancer survival (HR 0.65; 95% CI 0.55-0.77). In the subgroup analysis by ethnicity, a significant protective effect of metformin use on lung cancer risk was observed among Asian patients (HR 0.66; 95% CI 0.56-0.76), but not in European patients. On the other hand, the protective effect of metformin use on lung cancer survival was observed in both Asian (HR 0.57; 95% CI 0.49-0.66) and non-Asian (HR 0.79; 95% CI 0.71-0.88) patients. In the subgroup analysis by histology, a protective effect of metformin on lung cancer survival was observed in both non-small-cell lung cancer (HR 0.68; 95% CI 0.54-0.84) and small-cell lung cancer (HR 0.52; 95% CI 0.39-0.69). Funnel plot showed that no significant publication bias existed.

CONCLUSIONS

Our findings demonstrate that metformin is significantly associated with a decreased risk and increased survival in lung cancer.

摘要

已知和目的

二甲双胍由于其对癌症的潜在保护作用而受到越来越多的关注。我们旨在总结关于二甲双胍与 2 型糖尿病肺癌患者风险或生存的相关证据。

方法

我们选择了观察性研究，研究二甲双胍暴露与肺癌风险或生存之间的关系。在 PubMed、Cochrane Library、ScienceDirect、Wiley 和 SpringerLink 数据库中搜索了可用的出版物。使用风险比（HRs）和 95%置信区间（95%CI）作为肺癌风险或生存的效应测量值进行荟萃分析。

结果

共纳入 18 项研究（8 项关于肺癌风险，10 项关于肺癌生存）。二甲双胍治疗与肺癌发病率降低（HR 0.78；95%CI 0.70-0.86）和肺癌生存时间延长（HR 0.65；95%CI 0.55-0.77）相关。按种族亚组分析，亚洲患者使用二甲双胍对肺癌风险的保护作用显著（HR 0.66；95%CI 0.56-0.76），而欧洲患者则无此作用。另一方面，亚洲（HR 0.57；95%CI 0.49-0.66）和非亚洲（HR 0.79；95%CI 0.71-0.88）患者使用二甲双胍对肺癌生存的保护作用均有观察到。按组织学亚组分析，非小细胞肺癌（HR 0.68；95%CI 0.54-0.84）和小细胞肺癌（HR 0.52；95%CI 0.39-0.69）中，二甲双胍对肺癌生存的保护作用均有观察到。漏斗图显示不存在显著的发表偏倚。